HEALTH ACCESS ALERT
Tuesday, September 6, 2011
HEALTH BILLS UP FOR THE FINAL WEEK OF THE LEGISLATIVE SESSION
* Rate regulation bill AB52 (Feuer) held due to lack of support in the Senate
* Maternity mandate moves forward as SB222 (Evans) and AB210 (Hernandez)
* AB922 (Monning) would improve consumer assistance on health issues
* Other bills would also implement federal health reform and help get CA ready for 2014:
* AB1083 (Monning) would provide added protections to small businesses buying coverage
* AB1296 (Bonilla) would streamline eligibility and enrollment
* SB51 (Alquist) would adopt new national standards so premiums dollars go to patient care
* ABx1 21 and ABx1 30 by Assemblymember Blumenfield would extend MCO tax to maintain funding for Healthy Families coverage, and would prohibit shift to Medi-Cal for one year.
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The Assembly + Senate floor votes are being live-tweeted and blogged!
SACRAMENTO– This week is the end of the legislative session in Sacramento, as lawmakers scramble to get their bills passed before the end-of-week deadline. Legislation needs to pass both houses by this Friday, September 9th, or the bills are stalled for the year.
RATE REGULATION: The fate of the most prominent health bill of the year–and perhaps of any topic–is already known. Last Wednesday, Assemblymember Feuer, the author of the rate regulation bill AB52, announced that he was parking the measure for the year, due to the lack of support in the state Senate. The measure would have given state regulators the ability to deny unjustified rate hikes by health insurers. Despite an outpouring of strong support working families, small businesses, and consumers throughout California, not enough Senators were prepared to vote for any form of health insurance rate regulation.
The Senate floor vote was the last legislative hurdle in the process–and the highest, as it was where a similar bill died last year. This year, the effort restarted from scratch, and yet the support for the bill took it all the way through the full Assembly and the appropriate Senate committees. AB52 is now a two-year bill. For more on this, please see our blog post.
MATERNITY REBORN: The effort to require maternity care as a basic health insurance benefit is moving forward again. Bills earlier this week and this year were held in Assembly Appropriations Committee, despite amendments and negotiations that had removed industry opposition to the measures. Thankfully, this week the bill has been revived in the form of two separate bills, both moving forward.
AB210 (Hernandez) requires insurers to include maternity services as part of group coverage, and SB222 (Evans/Alquist) requires insurers in the individual market to do the same. The policy content of the bills has not changed, both going into effect in July 2012, 18 months before the requirements of the Affordable Care Act. If passed and signed by Governor Brown, this provides a long-sought consumer protection to California women, while also starting a smooth gradual transition to the new essential benefits package under federal health reform in 2014.
Those following the legislative health reform bills may recall that SB222 was formerly a bill to facilitate joint ventures between county-run health plans. Senator Alquist is expected to continue with that concept in another bill next year.
OTHER INSURANCE OVERSIGHT BILLS: There are other pending bills that would improve health insurance oversight and accountability.
For example, SB51(Alquist) would implement the new federal Medical Loss Ratio requirements in California and gives the state enforcement authority. The Medical Loss Ratio requires insurers to spend 85% of premium dollars on the delivery of health care in the large group market, and 80% of premium dollars in the individual and small group markets. This measure protects consumers and the value and confidence in products, ensuing that premium dollars go to patient care, not administration and profit.
AB1083 (Monning) implements changes in accordance with the federal Affordable Care Act that would reform the small group market and improve the ability of small businesses and self-employed Californians to purchase quality and affordable health care. For example, it adopts the requirement that prevents small businesses from being charged differently based on the health status of their workers. Support is needed to pass this measure on the Senate floor this week.
AB922 (Monning) seeks to improve consumer assistance for Californians with questions or compaints about health care and coverage. It would augment the Office of the Patient Advocate as a central place to take calls, and refer consumers to the appropriate departments. Insurers have opposed this effort to make it easier for consumers to get the help they need. New amendments to AB922 (Monning) also shift the OPA and the Department of Managed Health Care from the agency on Business, Transportation and Housing to the more appropriate and central Health and Human Services Agency. These improvements are to better serve both the millions of new health insurance consumers in 2014 and beyond, as well as the millions more with new rights, leading up to the full implementation of the federal health reform law.
Health consumer advocates are continuing to press forward with these measures, including the last two which face insurance industry lobbyists working to oppose additional oversight over their industry. Some insurance lobbyists, no longer worried about AB52, have deepened their efforts on these measures.
ELIGIBILITY AND ENROLLMENT: Another bill critical to the successful implementation of the federal health law is AB1296 (Bonilla), which would streamline eligibility and enrollment processes to create a seamless, “No Wrong Door” consumer experience for individuals seeking health coverage, whether from Medi-Cal or the new Exchange.
HEALTHY FAMILIES: Two bills crucial for maintaining funding for the Healthy Families program by Assemblymember Blumenfield are moving forward in the First Extraordinary session on the budget. For the purpose of continuing the funding for hundreds of thousands of children, ABx1 21 extends the Managed Care Organization (MCO) Tax to until July 2012. It also prevents the State from adopting the budget proposal that would move children from Healthy Families into Medi-Cal. Instead, ABx1 30 appropriates more money for the Healthy Families program. The bills are pending on the Assembly floor, awaiting a 2/3 vote, including from a few Republicans. On the Senate side, identical measures are numbered SBx1 9 and SBx1 12.
FINAL WEEK OF SESSION
This week is the last opportunity to pass bills off the Assembly and Senate floor. Bills must pass by both houses by September 9th before going to the Governor’s desk for signature. The Governor will then have until October 9th in order to sign or veto these measures.
Health Access will continue to track these bills, via these E-mail updates, as well as our blog, and Facebook and Twitter feeds.